Watchdog opposes plan to x-ray child asylum seekers

Plans to x-ray the teeth of unaccompanied child asylum seekers to assess their age contravene medical ethics and may constitute assault, the children's watchdog for England warns today.

Sir Al Aynsley-Green, the children's commissioner for England, says in a letter to the immigration minister, Liam Byrne, that there are "grave ethical reservations" surrounding the government's plans, as well as "severe limitations" to its effectiveness in identifying age. Young people who have never seen an x-ray machine will experience confusion and fear, but will be under pressure to consent because to refuse could reduce their chances of a successful asylum claim, he warns.

Aynsley-Green's concerns are shared by children's and medical organisations, including other UK children's commissioners, the British Medical Association and the Royal Colleges of Radiologists and of Paediatrics and Child Health. The government plans to change immigration rules by December 1 to allow medical examinations of children seeking asylum to try to determine their age.

This would permit not only dental x-rays - which the government said it wanted to introduce in a consultation paper on unaccompanied asylum-seeking children last February - but would also allow the use of x-rays of wrist and collar bones. Ministers want to assess children's age in order to identify what support and benefits they qualify for. There are concerns that some asylum seekers falsely claim to be under 18 because minors are given greater support and protection. There are nearly 3,000 age disputed cases each year.

Aynsley-Green, a consultant paediatrician for over 30 years, said: "Responsible medical authorities argue that since no dose of radiation can be entirely safe, then x-rays should never be used unless there is therapeutic benefit to the subject."

Many youngsters "may experience considerable fear of the procedure".

The Home Office said yesterday it was not committed to using x-rays, but had been consulting about changes to the system, including the possible use of x-rays, and would publish a summary of responses to the consultation in December.

In its February consultation paper, however, the Immigration and Nationality Directorate of the Home Office (now the Border and Immigration Agency) made clear it not only wanted to introduce dental checks "where there is a reasonable doubt about the claimed age", but also its view that an "unreasonable refusal to undergo an x-ray examination should strongly inform the final decision on age".

Aynsley-Green says: "Such explicit or, even worse, covert pressure is unacceptable, and could undermine the legality of any 'consent' so obtained. Furthermore, if such an investigation were to be performed without full consent, then it could possibly be judged to be an illegal assault on the child, exposing the practitioner to the scrutiny of the regulatory authorities." The children's commissioner also says that teeth and bone x-rays are inaccurate as a method of assessing age, with a margin for error of about two years.

Dr Hilary Cass, registrar at the Royal College of Paediatrics and Child Health, said: "There is no good research evidence for the use of x-rays for age assessment, and we would strongly urge that the Home Office review its position."